Women With Heart Disease Get Poorer Treatment Than Men

Main Category: Heart Disease
Article Date: 17 Dec 2007 - 17:00 PDT

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A paper in the latest issue of Menopause International argues that women with cardiovascular disease (CVD) have a worse outcome and are more likely to die than men once diagnosed.

CVD is the most common cause of death in women, yet there is a tendency to assume that it is a disease more likely to affect men. Women are undertreated even though they appear to do at least as well - and sometimes better - with treatments as men.

This may be because heart disease tends to affect women at an older age than it affects men, by which time they are more likely to be suffering from other illnesses such as diabetes and hypertension. Cardiovascular events are the leading cause of death among people with diabetes and women with diabetes have a significantly higher proportional risk of dying from CVD than men. There is also higher in-hospital and 30-day mortality after myocardial infarction in women in general, which can only partly be explained by their older age.

"Women with heart disease are an under-appreciated, under-treated iceberg of illness," says Dr Guy Lloyd, a consultant cardiologist at East Sussex NHS Trust and one of the authors of the paper. "Current methods to detect female heart disease, such as exercise treadmill tests, simply fail either to establish who is at risk or the subsequent chances of survival."

Gender difference also affects access to treatment. For example, women are less likely to receive standard medications for ischaemic heart disease and less likely to be enrolled on rehabilitation programmes. In addition, say the authors, women are less likely to receive an angiogram to assess the extent of coronary disease and consequently undergo less angioplasty and bypass operations.

Traditionally, cardiovascular studies have excluded or under-represented women and so the data relating to women and heart disease is unsatisfactory. There is a "pressing need", argue the authors, to ensure that cardiovascular trials are specifically designed to include women and that diagnosis and investigation programs are increasingly tailored towards investigations that are more likely to be helpful in women.

The British Menopause Society is a global opinion leader in the controversies on postmenopausal health through its journal, website and consensus statements. Members of the British Menopause Society receive Menopause International free of charge.

'Treating cardiovascular disease in women' , by Dr Guy Lloyd (consultant cardiologist) and Dr Wasing Taggu (specialist registrar in cardiology) is published in the December 2007 issue (Vol. 13) of Menopause International. The article is attached and is available free on the RSM Press website.

Menopause International is published every month by the Royal Society of Medicine. Dr Guy Lloyd is available for comment.

Founded in 1805, the Royal Society of Medicine is an independent organisation that promotes the exchange of knowledge, information and ideas in medical science and continued improvement in human health. http://www.rsm.ac.uk Registered Charity No. 206219

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